Using System Analysis and Personas for e-Health Interaction Design

Today, designers obtain more central roles in product and service development (Perks, Cooper, & Jones, 2005). They have to deal with increasingly complicated problems, like integrating the needs of various stakeholders while taking care about social, ethical and ecological consequences of their designs. To deal with this demanding design situation, they need to apply new methods to organize the available information and to negotiate the stakeholder’s perspectives. This paper describes how systems analysis supports the design process in a complex environment. In a case study, we demonstrate how this method enables designers to describe user requirements for complex design environments while considering the perspectives of various stakeholders. We present a design research project applying cybernetic systems analysis using the software ''System-Tools'' (Vester, 2002). Results from the analysis were taken to inform the design of an electronic patient record (EPR), considering the particularities of the German health care system. Based on the analysis, we developed a set of requirements for every stakeholder group, detailing the patients' perspective with persona descriptions. We then picked a main persona as reference for the EPR design. We describe the resulting design sketch and discuss the value of cybernetic systems analysis as a tool to deal with complex social environments. The result shows how the method helps designers to structure and organize information about the context and identify fruitful intervention opportunities for design. Keywords: E-Health; System Analysis, Cybernetics; Personas.</p

Acceptance model of electronic medical record

This paper discusses acceptance issues of Electronic Medical Record System (EMR), particularly in Malaysia. A detailed overview of EMR and its benefits are firstly discussed. A number of acceptance models are scrutinized. Then factors affecting EMR acceptance are put forward. Finally, before proposing an EMR acceptance model, an instrument formed by adapting and then finding its factors loading is presented

ANALYSIS OF EMR USER INTERFACE REQUIREMENT BY MEDICAL STUDENT

The aim of this study is to analyse user interface requirement for electronic medical record (EMR) system. This study is done through semi-structured interview with final year medical student. A participatory design approach was used to collect EMR user interface requirement from one of medical school in Malaysia. The scopes of analysis involve identifying the layout usage of user interface, navigation menu, navigation menu arrangement, user interface components and screen colour. The input collected from the study will be used to develop EMR user interface model

The Electronic medical record: Designing with the patient in mind

The transition from paper charts to Electronic Medical Records (EMR) is intended to create a more efficient health care industry. The use of EMRs eliminates paper waste and allows doctors and other medical staff to communicate with others conveniently wherever they happen to be located. Currently, the focus is on working through functionality and design issues in the hospital EMRs and getting doctors acquainted with how the EMR works. The patient focus has not been addressed at this time in terms of how they use and interact with their personal medical history. Based on my own personal experiences suffering from a chronic illness, I designed an EMR called iCareLog that is patient friendly and allows those with chronic health issues to keep track of their medical information and store it all in one convenient place

IMPROVING PCS 5.67 MEDITECH’S USER INTERFACE BY ADDING A “ONE-CLICK-ONE-SCREEN” ELECTRONIC PAGE

Medical organizations and physicians have been encouraged to implement different EHR systems. Initially these systems aimed to record, and store clinical data and improve its access and legibility. However, as these systems have become almost indispensable, users are demanding from these applications more complex tasks. Small practices and/or rural medical organizations often cannot afford to continuously upgrade their EHR systems or acquire modern systems. Research has shown that one way to solve this problem is to customize and add features that can facilitate user navigation. The purpose of this QI project was to investigate if integrating a “one-click-one-screen” electronic window displaying a snapshot of the most relevant and up-to-date patient information into PCS 5.67 Meditech was able to facilitate and improve data accessibility, information exchange, user satisfaction, patient care, and communication among the users. A pre-survey, given to 30 frequent users of PCS 5.67 Meditech, gathered their perception of the system’s UI. A “one-click one-screen” feature was designed however it was difficult to integrate it into the system’s UI because customization of this EHR system was complex beyond the local IT expertice. Nonetheless, the pre-survey data indicated that a significant number of PCS 5.67 Meditech users were dissatisfied with the performance of this EHR system. Additionally, the pre-survey data showed that the EHR system UI did not display clinical data in an efficient and user-friendly manner

PILOT PROJECT FOR ELECTRONIC REIMBURSEMENT SYSTEM FOR PHYSICIANS IN INDONESIA

A healthcare department in remove community of Indonesia aimed for reducing paperwork and improving the electronic system. As part of a pilot project, one aspect was replaced from manual to the electronic format. The proposed system was use of electronic form for claiming for fee reimbursement made by the physicians. The design of the system is intranet based and consisted of two separate portals. The first portal is for physicians and second portal is for billing clerk. The interface is user-friendly and packed with pre-defined codes set in several of its fields and sub-fields. The electronic form is also linked to a centralized database from which a physician can copy the existing patients record. For improving the system variance from individual needs, decision support algorithm is used. Whereas, for improving the system performance, machine learning algorithm is used. For data query, database query was designed. The relationship of columns in the database is displayed as a tabulated form to the user. In situation where a user selects a particular column, a filtered display mechanism displays those columns which satisfying the portion of the query already constructed. For obtaining data from the tabulated database, the SQL query is adapted. Rule-based knowledge inference model is utilized for reasoning about terminology and required domain knowledge. The inference used is algorithmic and helpful in performing all necessary tasks under the suitable billing circumstances. A survey is conducted with 35 physicians for judging their perception towards the system. Results of the survey indicate that most participants find the system suitable and better than the paper-based system in terms of several dimensions such as user friendliness, time saving, reducing errors, and accuracy

User Interfaces for Patient-Centered Communication of Health Status and Care Progress

The recent trend toward patients participating in their own healthcare has opened up numerous opportunities for computing research. This dissertation focuses on how technology can foster this participation, through user interfaces to effectively communicate personal health status and care progress to hospital patients. I first characterize the design space for electronic information communication to patients through field studies conducted in multiple hospital settings. These studies utilize a combination of survey instruments, and low- and high-fidelity prototypes, including a document-editing prototype through which users can view and manage clinical data to automatically associate it with progress notes. The prototype, activeNotes, includes the first known techniques supporting clinical information requests directly within a document editor. A usage study with ICU physicians at New York-Presbyterian Hospital (NYP) substantiated our design and revealed how electronic information related to patient status and care progress is derived from a typical Electronic Health Record system. Insights gained from this study informed following studies to understand how to design abstracted, plain-language views suitable for patients. We gauged both patient and physician responses to information display prototypes deployed in patient rooms for a formative study exploring their design. Following my reports on this study, I discuss the design, development and pilot evaluations of a prototype Personal Health Record application providing live, abstracted clinical information for patients at NYP. The portal, evaluated by cardiothoracic surgery patients, is the first of its kind to allow patients to capture and monitor live data related to their care. Patient use of the portal influenced the subsequent design of tools to support users in making sense of online medication information. These tools, designed with nurses and pharmacists and evaluated by cardiothoracic surgery patients at NYP, were developed using topic modeling approaches and text analysis techniques. Embodied in a prototype called Remedy, they enable rapid filtering and comparison of medication-related search results, based on a number of website features and content topics. I conclude by discussing how findings from this series of studies can help shape the ongoing design and development of patient-centered technology

Capture and Reuse of Knowledge in ICT-based Decisional Environments

Health care practitioners continually confront with a wide range of challenges, seeking to making difficult diagnoses, avoiding errors, ensuring highest quality, maximizing efficacy and reducing costs. Information technology has the potential to reduce clinical errors and to im-prove the decision making in the clinical milieu. This paper presents a pilot development of a clinical decision support systems (CDSS) entitled MEDIS that was designed to incorporate knowledge from heterogeneous environments with the purpose of increasing the efficiency and the quality of the decision making process, and reducing costs based on advances of in-formation technologies, especially under the impact of the transition towards the mobile space. The system aims to capture and reuse knowledge in order to provide real-time access to clinical knowledge for a variety of users, including medical personnel, patients, teachers and students.Clinical Decision Support Systems, Knowledge Management, Knowledge Interoperability, Mobile Interface, Object-relational Mapping

Developing quality heathcare software using quality function deployment: A case study based on Sultan Qaboos University Hospital

Development of software is one of the most expensive projects undertaken in practice. Traditionally, the rate of failure in software development projects is higher compared to other kinds of projects. This is partly due to the failure in determining software users’ requirements. By using Quality Function Deployment (QFD), this research focuses on identification and prioritization of users’ requirements in the context of developing quality health-care software system for Sultan Qaboos University Hospital (SQUH) in Oman. A total of 95 staff working at eight departments of SQUH were contacted and they were requested to provide their requirements in using hospital information systems. Analytic Hierarchy Process has been integrated with QFD for prioritizing those user requirements. Then, in consultation with a number of software engineers, a list consisting of 30 technical requirements was generated. These requirements are divided into seven categories and all of them are purported to satisfy the user needs. At the end of QFD exercise, continuous mirror backup from backup category, multi-level access from the security and confidentiality category, linkage to databases from application category emerge as technical requirements having higher weights. These technical requirements should receive considerable attention when designing the health-care software system for SQUH.Software quality; Quality function deployment; Healthcare software; Analytic Hierarchy Process